Kimberly Bergeron, FNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

AP3404 Issued in AZ

Practice address

3611 N Campbell Ave
Tucson, AZ 85719-1534

Phone

(520) 881-0636

Fax

(520) 881-0637

NPI assigned

Sep 21, 2009

Last updated

Mar 27, 2015By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• East Valley Urgent Care, LLC

  dba Urgent Care Extra-43rd&Bell

  • Urgent Care Clinic/Center
  • Phoenix, AZ
  • NPI 1619228335
  NPD (past)
• East Valley Urgent Care, LLC

  dba Urgent Care Extra-Ironwood

  • Urgent Care Clinic/Center
  • San Tan Valley, AZ
  • NPI 1649515347
  NPD (past)
• East Valley Urgent Care,LLC

  dba Urgent Care Extra-Bell

  • Urgent Care Clinic/Center
  • Phoenix, AZ
  • NPI 1235481128
  NPD (past)
• East Valley Urgent Care,LLC

  dba Urgent Care Extra-Elliott

  • Urgent Care Clinic/Center
  • Tempe, AZ
  • NPI 1710222419
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1253491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1427414400000",
    "number": "1275867590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1250 S CLEARVIEW AVE STE 100",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852093378",
            "telephone_number": "480-988-9108",
            "fax_number": "480-813-4460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3611 N CAMPBELL AVE",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857191534",
            "telephone_number": "520-881-0636",
            "fax_number": "520-881-0637"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERGERON",
        "first_name": "KIMBERLY",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-09-21",
        "last_updated": "2015-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AZ",
            "license": "AP3404",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "465975",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "Z169168",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• James Berger
• Jill Elizabeth Berger, MD
• Marcia Ronnie Berger, PT
• Olivia Noel Berger
• William G Berger, MD
• Todd James Bergeron
• Casey Kenan Bergeson
• Shaye Bergeson, RBT
• Edward J Berghausen, MD
• Amber Bergman

• Nurse Practitioner in Tucson, AZ
• Providers in Tucson, AZ by specialty
• Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.